TY - JOUR
T1 - Decisional conflict in breast cancer patients considering immediate breast reconstruction
AU - ter Stege, JA
AU - Oldenburg, HSA
AU - Woerdeman, LAE
AU - Witkamp, AJ
AU - Kieffer, JM
AU - van Huizum, MA
AU - van Duijnhoven, FH
AU - Hahn, DEE
AU - Gerritsma, MA
AU - Kuenen, MA
AU - Kimmings, NAN
AU - Ruhé, QPQ
AU - Krabbe-Timmerman, IS
AU - Riet, MV
AU - Corten, Eveline
AU - Sherman, KA
AU - Bleiker, EMA
N1 - Funding Information:
This trial is funded by the Dutch Cancer Society (Delflandlaan 17, 1062 EA , Amsterdam, The Netherlands) (grant number A6C/NKI 2014–7031 ). The funding body had no role in the design of the study, the collection, analysis and interpretation of the data, in writing the manuscript nor in the decision to submit the manuscript for publication.
Publisher Copyright:
© 2020 The Author(s)
PY - 2021/2
Y1 - 2021/2
N2 - Background: Breast cancer (BC) patients who are treated with mastectomy are frequently offered immediate breast reconstruction. This study aimed to assess decisional conflict in patients considering immediate breast reconstruction, and to identify factors associated with clinically significant decisional conflict (CSDC). Methods: Baseline data of a multicenter randomized controlled trial evaluating the impact of an online decision aid for BC patients considering immediate breast reconstruction after mastectomy were analyzed. Participants completed questionnaires assessing sociodemographic and clinical characteristics, decisional conflict and other patient-reported outcomes related to decision-making such as breast reconstruction preference, knowledge, information resources used, preferred involvement in decision-making, information coping style, and anxiety. Multivariable logistic regression analysis was performed to identify factors associated with CSDC (score > 37.5 on decisional conflict). Results: Of the 250 participants, 68% experienced CSDC. Patients with a slight preference for breast reconstruction (odds ratio (OR) = 6.19, p < .01), with no preference for or against breast reconstruction (OR = 11.84, p < .01), and with a strong preference for no breast reconstruction (OR = 5.20, p < .05) were more likely to experience CSDC than patients with a strong preference for breast reconstruction. Furthermore, patients with more anxiety were more likely to experience CSDC (OR = 1.03, p = .01). Conclusion: A majority of BC patients who consider immediate breast reconstruction after mastectomy experience clinically significant decisional conflict. The findings emphasize the need for decision support, especially for patients who do not have a strong preference for breast reconstruction.
AB - Background: Breast cancer (BC) patients who are treated with mastectomy are frequently offered immediate breast reconstruction. This study aimed to assess decisional conflict in patients considering immediate breast reconstruction, and to identify factors associated with clinically significant decisional conflict (CSDC). Methods: Baseline data of a multicenter randomized controlled trial evaluating the impact of an online decision aid for BC patients considering immediate breast reconstruction after mastectomy were analyzed. Participants completed questionnaires assessing sociodemographic and clinical characteristics, decisional conflict and other patient-reported outcomes related to decision-making such as breast reconstruction preference, knowledge, information resources used, preferred involvement in decision-making, information coping style, and anxiety. Multivariable logistic regression analysis was performed to identify factors associated with CSDC (score > 37.5 on decisional conflict). Results: Of the 250 participants, 68% experienced CSDC. Patients with a slight preference for breast reconstruction (odds ratio (OR) = 6.19, p < .01), with no preference for or against breast reconstruction (OR = 11.84, p < .01), and with a strong preference for no breast reconstruction (OR = 5.20, p < .05) were more likely to experience CSDC than patients with a strong preference for breast reconstruction. Furthermore, patients with more anxiety were more likely to experience CSDC (OR = 1.03, p = .01). Conclusion: A majority of BC patients who consider immediate breast reconstruction after mastectomy experience clinically significant decisional conflict. The findings emphasize the need for decision support, especially for patients who do not have a strong preference for breast reconstruction.
UR - http://www.scopus.com/inward/record.url?scp=85098488652&partnerID=8YFLogxK
U2 - 10.1016/j.breast.2020.12.001
DO - 10.1016/j.breast.2020.12.001
M3 - Article
VL - 55
SP - 91
EP - 97
JO - Breast
JF - Breast
SN - 0960-9776
ER -
